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Title: | Impact of telemedicine on the clinical outcomes and healthcare costs of patients with chronic heart failure and mid-range or preserved ejection fraction managed in a multidisciplinary chronic heart failure programme: A sub-analysis of the iCOR randomized trial |
Author: | Jiménez Marrero, Santiago Yun, Sergi Cainzos Achirica, Miguel Enjuanes, Cristina Garay, Alberto Farre, Nuria Verdú, Jose M. Linas, Anna Ruiz, Pilar Hidalgo, Encarnación Calero, Esther Comín Colet, Josep |
Keywords: | Insuficiència cardíaca Malalties cròniques Telecomunicació en medicina Heart failure Chronic diseases Telecommunication in medicine |
Issue Date: | 1-Jan-2020 |
Publisher: | SAGE Publications |
Abstract: | Background The efficacy of telemedicine in the management of patients with chronic heart failure and left ventricular ejection fraction ≥40% is poorly understood. The aim of our analysis was to evaluate the efficacy of a telemedicine-based intervention specifically in these patients, as compared to standard of care alone. Methods The Insuficiència Cardiaca Optimització Remota (iCOR) study was a single centre, randomised, controlled trial, designed to evaluate a telemedicine intervention added to an existing hospital/primary care multidisciplinary, integrated programme for chronic heart failure patients. 178 participants were randomised to telemedicine or usual care, and were followed for six months. For the present sub-analysis, only iCOR participants (n = 116) with left ventricular ejection fraction ≥40% were included. The primary study endpoint was the incidence of an acute non-fatal heart failure event, defined as a new episode of worsening of symptoms and signs consistent with acute heart failure requiring intravenous diuretic therapy. The healthcare-related costs in each study group were also evaluated. Results The incidence of the first occurrence of the primary endpoint was significantly lower in the telemedicine arm (22% vs 56%, p<0.001), with a hazard ratio of 0.33 comparing to the usual care arm (95% confidence interval 0.17-0.64). Telemedicine was also associated with lower mean overall chronic heart failure care-related costs compared to usual care (8163¿ vs 4993¿, p=0.001). The results were consistent in both left ventricular ejection fraction of 40-49% and left ventricular ejection fraction ≥50% patients. Conclusions Our results suggest that telemedicine is a promising strategy for the management of chronic heart failure patients with left ventricular ejection fraction ≥40%. These findings should be replicated in larger cohorts. |
Note: | Versió postprint del document publicat a: https://doi.org/10.1177/1357633X18796439 |
It is part of: | Journal of Telemedicine and Telecare, 2020, vol. 26, num. 1-2, p. 64-72 |
URI: | http://hdl.handle.net/2445/173776 |
Related resource: | https://doi.org/10.1177/1357633X18796439 |
ISSN: | 1357-633X |
Appears in Collections: | Articles publicats en revistes (Ciències Clíniques) Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL)) |
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